New Jersey

Main Contact: 
Nancy Day: Nancy[dot]day[at]dhs[dot]state[dot]nj[dot]us
NWD/SEP System
Name of Operating Agency: 
Division of Aging Services
Participating types of NWD/SEPs: 
21 AAA/ADRCS will act as the foundation for a network of NWD/SEP agencies and partnerships.
1-800 number: 
844-646-5347
Level I screen: 
Modified InterRAI HC. The primary screen is NJ Choice, with 20 clinical and 20 financial questions, modified to fit all populations.
Level II assessment: 
NJ Choice will encompass a Level II assessment tool that is currently being developed. Along with the Level I screen, the Level II tools will identify five level of care needs: 1) information and assistance; 2) homemaker; 3) intermittent personal care; 4)
Agency responsible for completing the financial assessment: 
21 county welfare agencies
Coordination/automation of referrals between levels (i.e., Level I and Level II) : 
Level I and Level II are both included within the NJ Choice assessment. Based on the outcome of the Level I screen, consumers may be referred to the state. The DHS will ensure that the MCOs are fully trained to conduct the assessments.
Core Standardized Assessment
Elderly individuals (age 65 or older): 
NJ Choice (interRAI assessment); Screening Tool for Community Services
People with developmental disabilities: 
interRAI
People with a serious mental illness or severe emotional disturbance: 
Individual Needs for Discharge Assessment (only for individuals in state hospitals); trigger questions on Level 1 Screen for PASRR; other specific-use assessment tools such as PHQ-9
People with physical disabilities: 
NJ Choice (interRAI assessment); Screening Tool for Community Services
Conflict-Free Case Management
Mitigation strategies in place/planned: 
Under MLTSS, NJ will conduct assessments for new Medicaid beneficiaries. Re-determinations will be conducted by the MCOs with state approval and analysis of data.
Service data: 

Claims data and encounter data are used for data for administrative, financial and quality control purposes.

Quality measures: 

Mental Health: Global Level of Functioning (GLOF); Mental Health Statistical Improvement Program (MHSIP) Consumer Survey; Critical Incident Report

Developmental/Intellectual Disability: OPIA, DDL Licensing Inspection System Report; Day/ Employment Audit Activity Report; Qualified Provider Report; Unusual Incident Reporting System (UIRMS); Medicaid Adult Health Quality Measures; CCW/Five Percent Platform; Accrediting Bodies; Unusual Incident Reports

Elderly: Participant File Review Tool; Participant Satisfaction Survey; Level of Care; Plan of Care; Provider Network; Critical Incident Report; Complaints, Grievance and Appeals

Physical Disability: Participant File Review Tool; Participant Satisfaction Survey; Level of Care; Plan of Care; Provider Network; Critical Incident Report; Complaints, Grievance and Appeal; Unusual Incident Reports: Division of Developmental Disabilities, Office of Licensing

How are results made available to LTSS Providers? A copy of the CMS 372 Report will be forwarded on an annual basis; DHS has established an internal MLTSS Quality Strategy work group that has been meeting to develop measures, methods, frequency, data sources and who will be responsible for each quality measure.

Outcomes data: 

MFP; Quality of Life Survey; CAHPS; Participant Experience Survey (PES); National Core Indicators (NCI)

Other

  • Participant File Review Tool
  • Comprehensive Audits, Targeted Interim Audits, QI Topic Audits
  • State Medicaid Annual
  • Operating Agency tracking System
  • Olmstead Review Process: 30, 60, 90 Survey
Use of Enhanced FMAP: 

NJ is using program funds to expand HCBS for Medicaid recipients through MLTSS under the New Comprehensive Medicaid Waiver (CMW). NJ is also supporting mental health transitions by covering supportive services such as outpatient therapy, counseling and case management.